Limited English Proficiency is a Risk for CLABSI in Pediatric Hematopoietic Cell Transplant or Cellular Therapy Recipients.

OBJECTIVES:Pediatric patients undergoing hematopoietic transplant or cellular therapy (TCT) are at increased risk of developing central line-associated bloodstream infections (CLABSI). The role of language barriers in CLABSI risk has not been well-explored in this population. This study aimed to evaluate the risk for CLABSI in pediatric TCT patients with limited English proficiency (LEP). DESIGN AND PATIENTS:A retrospective cohort study of patients hospitalized in the TCT unit in a single pediatric oncology center between January 2021 and June 2024. INTERVENTIONS:Clinical data was abstracted from the electronic health records and CLABSI events from the hospital infection prevention and control surveillance database. CLABSI rates were calculated as events per 1,000 inpatient central line days (CLD) and compared between patients with LEP and those English-proficient. Cox proportional hazard analysis was used to evaluate independent risk factors for CLABSI. RESULTS:Two hundred and eighty patients contributed a total of 12,325 CLD and 93 CLABSIs; of which 57 patients were with LEP contributing 3,113 CLD and 29 CLABSIs. The unadjusted CLABSI rate in patients with LEP was significantly higher (9.32/1,000 CLD) than that in English-proficient patients (6.95/1,000 CLD, P < .001). Patients with LEP had twice the risk of developing CLABSI compared to English-proficient patients (Adjusted HR 2.03, 95% CI [1.23, 3.34]). CONCLUSIONS:This study identified a significantly increased risk of CLABSI in pediatric TCT patients with language barriers. Addressing these barriers through equitable strategies is crucial for improving clinical outcomes and promoting an inclusive healthcare for diverse patient groups.